Name of the Procedure:

All Lower Extremity Prostheses, Foot, Flexible Keel
Common name(s): Flexible keel foot prosthesis
*Technical/medical term: HCPCS Code L5972 Foot, prosthesis, lower extremity (flexible keel)

Summary

A flexible keel prosthesis is an artificial foot designed to mimic the natural flexibility and movement of the human foot. It enhances stability and allows for a smoother walking gait.

Purpose

Medical Conditions/Problems Addressed

• Amputation of the lower extremity
• Mobility impairment due to the loss of a foot

Goals/Expected Outcomes

• Restoring the ability to walk with greater ease and stability
• Improving overall comfort and functionality in daily activities

Indications

Symptoms/Conditions

• Lower limb amputation below the knee
• Severe foot deformities requiring amputation

Patient Criteria

• Individuals who have undergone a below-knee amputation
• Patients seeking improved mobility and comfort compared to standard prosthetic feet

Preparation

Pre-Procedure Instructions

• Follow up with a prosthetist for measurement and fitting sessions
• Discuss daily activity level and specific needs with the healthcare team

Diagnostic Tests/Assessments

• Comprehensive physical examination
• Assessment of limb condition and residual limb health
• Possible gait analysis

Procedure Description

Steps Involved

1. Consultation and Measurement: The prosthetist evaluates the residual limb and takes precise measurements.
2. Customization: The flexible keel foot prosthesis is customized to match the patient’s anatomy and activity level.
3. Fitting: The prosthetist fits the prosthesis to the residual limb, making necessary adjustments for comfort and alignment.
4. Training: The patient undergoes physical therapy to learn to walk with the new prosthesis.

Tools/Equipment/Technology

• Measurement tools
• Prosthetic components (socket, flexible keel foot)
• Alignment devices

Anesthesia/Sedation Details

• None required for fitting and adjustment

Duration

The initial fitting process typically takes a few hours, including adjustments for comfort and alignment. Additional follow-up sessions may be required.

Setting

• Outpatient clinic
• Prosthetist's office

Personnel

• Prosthetist
• Physical therapist
• Medical doctor (for initial evaluation and follow-up)

Risks and Complications

Common Risks

• Skin irritation or sores from improper fit
• Discomfort during the breaking-in period

Rare Risks

• Allergic reaction to prosthetic materials
• Long-term joint pain from misalignment

Possible Complications

• Infections at the site of the residual limb
• Mechanical failure of the prosthesis

Benefits

• Improved mobility and balance
• Enhanced comfort and natural movement
• Increased ability to perform daily activities
• Psychological benefits from improved independence

Recovery

Post-Procedure Care

• Regular follow-up appointments for adjustments
• Proper skin care of the residual limb
• Wearing a shrinker sock to reduce swelling

Expected Recovery Time

• Initial acclimation period of a few weeks
• Full adjustment may take several months

Restrictions/Follow-Up

• Gradual increase in activity level as tolerated
• Regular follow-up with the prosthetist for alignment checks and maintenance

Alternatives

Other Treatment Options

• Standard prosthetic foot
• High-energy return feet
• Microprocessor-controlled feet

Pros and Cons

• Flexible keel: Better for low to moderate activity levels, provides a smoother gait.
• High-energy return: Suited for highly active individuals, more expensive.
• Microprocessor feet: Advanced functionality, but much more costly.

Patient Experience

During the Procedure

• No pain or discomfort during the fitting process
• Initial feeling of awkwardness as the patient gets used to the new prosthesis

After the Procedure

• Some initial discomfort as the body adjusts to the new prosthesis
• Soreness or irritation possible at contact points; alleviated with adjustments
• Physical therapy helps improve gait and comfort
• Ongoing support from a healthcare team for optimal results